Tuesday, April 19, 2016

The $881,223,855 in spending West Virginia lawmakers won't look at

A bad economy and 82 years of bad economics will shrink West Virginia tax revenues next year. The Democratic governor will take a guess at how big the "hole" will be next year and reconvene the first Republican Legislature since 1930. Liberals and big businesses (perhaps now a redundancy as so many CEOs now act like SJWs) will push for tax increases. This is unnecessary,

That is how much the state ponies up for the Medicaid program, a $3.3 billion annual gift to the medical industry in the state. Ostensibly, the money provides basic health care for the state's down and out, but the reality is that the state has extended coverage far beyond the minimum. The care comes with no premiums, no deductibles, and best of all, no appointments are necessary. People on Medicaid can simply go to the local hospital emergency room and get routine treatment.

Of course, taxpayers are on the hook for premium prices in the emergency room. Hospitals claim they lose money on emergency rooms but must keep them open. Hospital costs are not the taxpayer's problem. That is the hospital's problem. They are only required to treat emergencies in the emergency room. They could turn down routine serves, but because taxpayers are dumb enough to pay extra, hospitals provide routine care at ER prices.

And there are other services that could be reduced or dropped. A thorough review is needed. The test is whether it is a service vital to keeping someone alive or "preventive medicine." Bear in mind, this is not Preventicare. As for saving money in the long run, if that were true then after 50 years of Medicare, our streets would be paved with gold instead of potholes.

But hospitals and doctors are the most powerful lobbying group in the nation. They have worked charity care into a half-trillion-dollar a year revenue stream nationally. That is what Medicaid costs the federal and state governments each year.

Then there are drugs. West Virginia has had the nation's highest overdose death rate for a decade. Much of this stems from prescription drugs. I do not doubt that Medicaid funds much of the prescription drug abuse. It is the element of opioid abuse no one talks about. Certainly we should at least monitor this. Had we worked on this instead of wasting time arguing over requiring prescriptions for Sudafed (the Gazette's false flag operation) we would have this under control by now.

As for fraud, Attorney General Patrick Morrisey wants the power to go after it. I am reluctant to give prosecutorial power to that office (two words: Darrell McGraw) but certainly the Legislature can enable his office can work with the State Police on a Medifraud crackdown. I would begin with a thorough audit of CAMC and work my way down. Of course, the medical lobby would ride me out of town on a rail.

Medicaid is a scared cow that has outgrown the barn. The program is the largest budget item in West Virginia government, dwarfing education. The state spends more than four times as much on Medicaid as it does prisons.

Surely after years of exponential growth, the program can afford a one-time 10 percent cut.

6 comments:

Excellent suggestion. As a complementary recommendation I would suggest stopping payments (cash, SNAP cards, housing, etc.) to able-bodied adults who do not work. I wonder how much West Virginia spends on those programs? Maine started a work requirement for SNAP and lowered their rolls by 80 per cent. - Elric

Can someone tell me why ER care is so expensive? Why should it be more expensive than regular healthcare for the same procedures, etc.? I've been to the ER only once in my entire life, and in my case I found the care to be significantly substandard. Given the long wait to see a physician and the poorer quality of the care, I should have been charged less, not more, for my ER visit.

The real, permanent answer is to abolish all occupational licensing. Medical licensing has been in place for a hundred years in almost all of western civilization, and it has created a hyper regulated monopoly where costs can only be kept down by rationing, and that has been proven not to work. The costs of medical care are the driver of the welfare state and the welfare state is bankrupting all of us. Medical licensing gave birth to all of this. Abort it.